VIRCA Statement Builder
Patient Condition
Voluntary
Free from coercion
No undue influence
Decision made independently
Informed
Condition explained
Risks of refusal discussed
Potential outcomes explained
Plain language used
Relevant
Hospital
Urgent Care Clinic
GP
Capacity
Alert and oriented
Understood information
Weighed options and communicated decision
No cognitive impairment
Advice
Call 000 if symptoms worsen
Follow up with GP
Remain with responsible adult
Attend hospital if symptoms worsen
Attend Urgent Care Clinic
Maintain hydration and rest
Generated VIRCA Statements
Voluntary:
Informed:
Relevant:
Capacity:
Advice:
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